Individual provider Active NPI

Richard Diego Maffezzoli, M.D.

  • Internal Medicine Physician
  • Naples, FL
National Provider Identifier
1669438214
Registry record updated Mar 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME117859 Issued in FL
Practice address
1735 SW Health Pkwy
Ste. 201
Naples, FL 34109-0421
Phone
(239) 249-7800
Fax
(239) 249-7803
NPI assigned
Apr 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D07132 MD
Internal Medicine Physician 207R00000X ME117859 FL Primary

Addresses

Primary practice location

1735 SW Health Pkwy
Ste. 201
Naples, FL 34109-0421

Mailing address

3434 Hancock Bridge Pkwy
Ste. 301
North Fort Myers, FL 33903-7094
Phone (877) 856-3774

Other identifiers 1

IdentifierTypeStateIssuer
025571800MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071231000135 MD Practitioner - Internal MedicinePractitioner - Endocrinology 8820985054 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Endocrinology
Education
Johns Hopkins University School of Medicine, 1966
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

515 Fairmount Ave
Suite 340
Towson, MD 21286-5466
Phone (410) 494-1234

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
The Good Samaritan Hospital of Maryland, Inc. Past Accepting new patients
Medstar Good Samaritan Physicians LLC Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1145836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393891200000",
    "number": "1669438214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3434 HANCOCK BRIDGE PKWY",
            "address_2": "STE. 301",
            "city": "NORTH FORT MYERS",
            "state": "FL",
            "postal_code": "339037094",
            "telephone_number": "877-856-3774",
            "fax_number": "239-599-2625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1735 SW HEALTH PKWY",
            "address_2": "STE. 201",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341090421",
            "telephone_number": "239-249-7800",
            "fax_number": "239-249-7803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAFFEZZOLI",
        "first_name": "RICHARD",
        "middle_name": "DIEGO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-24",
        "last_updated": "2014-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D07132",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME117859",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "025571800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

Verify at the official NPI Registry.